Acta oncologica (Stockholm, Sweden) · 2016
Optimal gross tumor volume definition in lung-sparing intensity modulated radiotherapy for pleural mesothelioma: an in silico study.
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Botticella Angela, Defraene Gilles, Nackaerts Kristiaan, Deroose Christophe M, Coolen Johan, Nafteux Philippe, Peeters Stephanie, Ricardi Umberto, De Ruysscher Dirk
Аннотация
BACKGROUND: The gross tumor volume (GTV) definition for malignant pleural mesothelioma (MPM) is ill-defined. We therefore investigated which imaging modality is optimal: computed tomography (CT) with intravenous contrast (IVC), positron emission tomography-CT (PET/CT) or magnetic resonance imaging (MRI).
MATERIAL AND METHODS: Sixteen consecutive patients with untreated stage I-IV MPM were included. Patients with prior pleurodesis were excluded. CT with IVC, 18FDG-PET/CT and MRI (T2 and contrast-enhanced T1) were obtained. CT was rigidly co-registered with PET/CT and with MRI. Three sets of pleural GTVs were defined: GTVCT, GTVCT+PET/CT and GTVCT+MRI. Quantitative and qualitative evaluations of the contoured GTVs were performed.
RESULTS: Compared to CT-based GTV definition, PET/CT identified additional tumor sites (defined as either separate nodules or greater extent of a known tumor) in 12/16 patients. Compared to either CT or PET/CT, MRI identified additional tumor sites in 15/16 patients (p = .7). The mean GTVCT, GTVCT+PET/CT and GTVCT+MRI [±standard deviation (SD)] were 630.1 cm3 (±302.81), 640.23 cm3 (±302.83) and 660.8 cm3 (±290.8), respectively. Differences in mean volumes were not significant. The mean Jaccard Index was significantly lower in MRI-based contours versus all the others.
CONCLUSION: As MRI identified additional pleural disease sites in the majority of patients, it may play a role in optimal target volume definition.
MATERIAL AND METHODS: Sixteen consecutive patients with untreated stage I-IV MPM were included. Patients with prior pleurodesis were excluded. CT with IVC, 18FDG-PET/CT and MRI (T2 and contrast-enhanced T1) were obtained. CT was rigidly co-registered with PET/CT and with MRI. Three sets of pleural GTVs were defined: GTVCT, GTVCT+PET/CT and GTVCT+MRI. Quantitative and qualitative evaluations of the contoured GTVs were performed.
RESULTS: Compared to CT-based GTV definition, PET/CT identified additional tumor sites (defined as either separate nodules or greater extent of a known tumor) in 12/16 patients. Compared to either CT or PET/CT, MRI identified additional tumor sites in 15/16 patients (p = .7). The mean GTVCT, GTVCT+PET/CT and GTVCT+MRI [±standard deviation (SD)] were 630.1 cm3 (±302.81), 640.23 cm3 (±302.83) and 660.8 cm3 (±290.8), respectively. Differences in mean volumes were not significant. The mean Jaccard Index was significantly lower in MRI-based contours versus all the others.
CONCLUSION: As MRI identified additional pleural disease sites in the majority of patients, it may play a role in optimal target volume definition.
Предметные рубрики MeSH
AgedComputer SimulationFemaleFluorodeoxyglucose F18Follow-Up StudiesHumansLungLung NeoplasmsMagnetic Resonance ImagingMaleMesotheliomaMesothelioma, MalignantMultimodal ImagingNeoplasm StagingOrgan Sparing TreatmentsPleural NeoplasmsPositron Emission Tomography Computed TomographyPrognosisProspective StudiesRadiopharmaceuticalsRadiotherapy Planning, Computer-AssistedRadiotherapy, Intensity-ModulatedRetrospective StudiesSurvival RateTumor Burden